SCOTT W DIVENERE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033140

License Status

EXPIRED

Business

First Name

SCOTT

Middle

Last Name

DIVENERE

Suffix

Business Name

SCOTT W DIVENERE MD

Original Issue Date

06/07/1995

Effective Date

06/07/1995

Expiration Date

06/30/2000

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

09/22/2006